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Neuroanatomy 2 > sleep lecture > Flashcards

sleep lecture Flashcards

1
Q

What is sleep?

A

Reversible
Behavioral state of
perceptual disengagement from
Unresponsiveness to the environment

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2
Q

Some features of normal sleep

A
  1. Postural recumbency
  2. quiescence
  3. closed eyes
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3
Q

What defines sleep stages:

A
  1. EEG
  2. EOG - electrooculogram
  3. EMG of chin muscle tone (axial muscle tone)
    (4. Polysomnogram - PSG measures respiratory effort, oxygenation, ECG, surface EMG - limbs)
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4
Q

What are some key neurotransmitters of the waking state?

A
  1. Histamine (tuberomamillary nucleus)
  2. NE (locus ceruleus)
  3. Serotonin (Raphe nuclei)
  4. Ach (basal forebrain)
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5
Q

Features of the waking state

A
  1. EEG: Low voltage, high frequency, dominant alpha rhythm
  2. EOG: rapid,blinking
  3. EMG: muscle tone is high
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6
Q

Features of stage N1 - very light quality sleep or sleep disruption

A
  1. EEG: <50% alpha, mostly theta activity
  2. EOG: slow roving eye movement
  3. EMG: Muscle tone is high
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7
Q

Features of stage N2

A
  1. EEG: Vertex K complexes, high voltage negative and positive discharges with spindles (~0.5s)
  2. EOG: Still
  3. EMG: Muscle tone is high
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8
Q

Features of stage N3

A
  1. EEG: Slow wave activity, high voltage, low frequency
  2. EOG: Still
  3. EMG: Muscle tone is LOW
  4. Homeostatic sleep
  5. reduced BP,HR, Cardiac output, RR
  6. GH release
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9
Q

Features of REM sleep

A
  1. EEG: Mixed frequency, low voltage, saw tooth waves
  2. EOG: rapid eye movements
  3. Muscle tone VERY low (paralyzed)
  4. Cholinergic brain state
  5. Irregular respiration, arrthymias, heart rate variation, classical dreaming state
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10
Q

What is the tonic phase of REM sleep?

A
  1. Impaired thermoregulation
  2. hypotension
  3. bradycardia
  4. increased CBF
  5. Increased ICP
  6. increased RR
  7. Erection
  8. ATONIA
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11
Q

What is the phasic phase of REM sleep?

A
  1. Vasoconstriction
  2. Increased BP
  3. Tachycardia
  4. Increases in CBF
  5. Increases in RR
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12
Q

How is REM sleep generated?

A
  1. Pons is a critical structure
  2. REM-on and REM-off cells
  3. Interaction between NE, 5HT, LDTN/PPN
  4. Sublateral dorsal and preceruleus (GABA) interact with vIPAG and LPT REM-off cells (REM flip-flop; Saper Nature)
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13
Q

What does a hypnogram for rem sleep look like?

A
  1. 90 minute cycles
  2. Increasing REM time, decreases SWS
  3. Stage N1 ~5%
  4. Stage N2 ~50%
  5. Stage N3 ~20%
  6. REM ~25%
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14
Q

What are some features of control of sleep?

A
  1. Process S- sleepiness Process C - circadian
  2. orexin/hypocretin project to POST hypothal
  3. sleep onset correlates with activity of VLPO (ant hypoth) - ANTERIOR HYPOTH
  4. Hypnogenic peptides IL-1 - TNF - sick want to sleep
  5. Adenosine increases with time spent awake - improve alertness with caffeine adenosine antagonist
  6. Dim light suppresses melatonin (rises in the evening)
  7. Increase in glymphatic space
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15
Q

How many hours of sleep do new borns get? How much REM sleep?

A

18 hours, 50% REM

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16
Q

How many hours of sleep do adolescents get?

A

10 hours

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17
Q

How many hours of sleep do adults get?

A

7-9 hours but get insufficient amounts

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18
Q

How many hours do elderly get?

A

reduced sleep due to sleep disorders

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19
Q

What changes in delta sleep ?

A

Decreases with age, confounded by definitional problems

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20
Q

What is sleep onset latency?

A

Time from lights out to sleep (~10min)

21
Q

What is REM latency?

A

Time from sleep onset to REM sleep (~90min)

22
Q

What is sleep efficiency?

A

Time asleep/Time in bed (~90%)

23
Q

What drugs are associated with increases in sleep?

A
  1. antihistamines
24
Q

How are benzodiazepines associated with sleep?

A
  1. benzodiazepines reduce slow wave sleep
25
Q

how are antidepressants associated with sleep?

A
  1. Antidepressants (MAO-i, SSRI, TCA) reduce REM, prolong REM latency
26
Q

How are SSRIs associated with sleep?

A

alter muscle tone

produce roving eye movements in light sleep

27
Q

How does alcohol alter sleep?

A

Hastens sleep onset but associates with increased arousal

28
Q

What are key markers of circadian rhythms?

A
  1. Temperature
  2. REM timing
  3. cortisol - rise in the morning whether you sleep or not - sleep doesn’t influence this
29
Q

How is the nature of circadian vs sleep effects revealed?

A

By forced descychronization

30
Q

How is circadian rhythm controlled?

A

transplantation of suprachiasmatic nuclei

31
Q

What are the SCN afferents for circadian control?

A
  1. retinohypothalamic
  2. lateral geniculate
  3. Raphe
32
Q

What are the SCN Efferents for circadian control?

A
  1. Paraventricular nuclei
  2. hypothalamus
  3. thalamus
  4. dorsomedial hypothal
33
Q

What are some clock genes

A
  1. Clock
  2. Bmal
  3. Per
  4. Cry
34
Q

There is a strong influence of the SCN on slave organs which are those?

A

Kidney

Liver

35
Q

Sleep apnea more common in..

A

early morning - worse in REM sleep

36
Q

What is apnea

A

cessation of breathing for 10 seconds

37
Q

Hypopnea

A

Reduced breathin/ariflow 10 seconds

38
Q

Obstructive apnea

A

Airway closed and paradoxical breathing

39
Q

Central apnea

A

No movement of ribcage/abdomen
brainstem problem
broken neck kink in medulla
common in myotonic dystrophy

40
Q

how do you distinguish rsetless leg from a neuropathy

A
  • circadian component

- movement component

41
Q

What is period limb movement/

A

Cyclical - predictable
Manifests as restless leg (the sensation)
90% of RLS have PLMD
50% of PLMD have RLS

42
Q

CAUSES of RLS/PLMD

A
  1. central spasticit - PNS - MS - neurpathy
  2. alcohol use
  3. pregnancy (iron deficiency - fetus taking iron away)
43
Q

Treatment of RLS

A
  • supplement with iron or folate
  • Dopaminergic AGONIST
  • Sinemet (augments) - PD disease - only works for 6 months
  • Clonazepam (tachyphylaxis)
  • Opoids - exception circumstance
44
Q

what is the classis tetrad for narcolepsy

A
  1. excessive day time sleepiness
  2. cataplexy - telling a joke then collapsing
  3. hypnagogic hallcuinations
  4. sleep paralysis
    go into REM earlu - before 90min
    Autoimmune BASIS - HLA
    H1N1 - can be associated with this
45
Q

How do you improve alertness in narcoplepsy?

A

Use amphetamines/alerting agents

- Anticataleptics - Anticholinergics, TCAs, SSRIs, Methylphenidate

46
Q

How do Orexin and hypocretin work?

A

Knock out induces narcolepsy

47
Q

Sleep walking would occur

A

First third of the night

48
Q

REM Sleep behavior disorder occurs

A

LAST THIRD of the night

Neuroanatomy 2 (25 decks)

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